Phubbing as a Millennials’ New Addiction and Relating Factors Among Nursing Students

Objective This study investigated phubbing (the act of ignoring one’s companion or companions to pay attention to one’s smartphone) and examined the factors affecting phubbing among nursing students in South Korea. Methods A cross-sectional survey design was adopted, and a self-reported questionnaire was used. Data were collected from 200 nursing students in two cities. Self-administered questionnaires included demographic data, smartphone addiction, media multitasking motivation, interpersonal competency, and phubbing. Results Phubbing was positively correlated with smartphone addiction (r=0.41, p<0.001) and media multitasking motivation (r=0.16, p<0.05), and negatively correlated with interpersonal competence (r=-0.51, p<0.001). Factors influencing nursing students’ phubbing were interpersonal competency (β=-0.59, p<0.001), media multitasking motivation (β=0.24, p<0.001), smartphone addiction (β=0.19, p<0.01) and interpersonal relationships (β=0.14, p<0.05). The model including these variables accounted for 43% of variance in phubbing. Conclusion Nursing students showed a moderate level of phubbing, and interpersonal competency was an important factor for reducing their phubbing of nursing students. Since phubbing occurs frequently among nursing students, educators in nursing are required to develop and implement active interventional measures to help nursing students avoid phubbing and improve their interpersonal relationships by increasing their empathic ability and communication skills.     

The Influence of Physical Distancing,Sense of Belonging,and Resilience of Nursing Students on Their Viral Anxiety During the COVID-19 Era

ObjectiveWe aimed to explore how nursing students’ adherence to physical distancing, sense of belonging, or resilience may be associated with viral anxiety during the coronavirus disease (COVID-19) era in South Korea. MethodsWe conducted an online survey among nursing students from December 8–10, 2021. The survey gathered participants’ age, sex, grades, living area, and responses to questions on COVID-19. In addition, responses to Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), adherence to physical distancing, Sense of Belonging Instrument, Calling and Vocation Questionnaire, Patient Health Questionnaire-9 items (PHQ-9), and Connor-Davidson Resilience Scale-2 (CD-RISC2) items were gathered. ResultsThe SAVE-6 score was significantly correlated with adherence to physical distancing (r=0.29), PHQ-9 (r=0.26), and CD-RISC2 (r=-0.34, all p<0.01) similar to partial correlation analysis adjusting participants’ group (freshmen and sophomores vs. juniors and seniors). A linear regression analysis revealed that viral anxiety of nursing students was predicted by sex (female, β=0.20, p=0.001), adherence to physical distancing (β=0.25, p<0.001), sense of belonging (β=0.16, p=0.014), and CD-RISC2 score (β=-0.32, p<0.001) (adjusted R²=0.24, F=10.01, p<0.001). ConclusionWe observed that adherence to physical distancing, sense of belonging, and their resilience influenced nursing student’s viral anxiety. An appropriate support system to manage viral anxiety is needed for nursing students during the COVID-19 pandemic.     

Effects of Cognitive-Behavioral Therapy Based Music Therapy in Korean Adolescents with Smartphone and Internet Addiction

Objective The purpose of this study was to evaluate the effects of adding music therapy (MT) to cognitive-behavioral therapy (CBT) on symptoms of smartphone/internet addiction and psychiatric comorbidities. Methods Overall, 155 patients diagnosed with addiction were assigned to either the CBT-MT group or CBT group. Both groups received CBT for 8 weeks, while the CBT-MT group received additional MT. The intervention was completed by 67 and 71 participants in the CBT-MT and CBT groups, respectively. Results The total scores of Young Internet Addiction Scale (YIAT) and Smartphone Addiction Proneness Scale (SAPS) decreased significantly (p<0.001 for both) in both groups, while the total scores of State Anxiety Inventory for Children (SAIC) (p<0.001), Trait Anxiety Inventory for Children (TAIC) (p<0.001), Conners-Wells’ Adolescent Self-Report Scale-Short form (CASS(S)) (p=0.048), and Barratt Impulsiveness Scale-11 (BIS-11) (p<0.001) decreased only in the CBT-MT group. The decrements in YIAT (p=0.025), SAIC (p=0.043), TAIC (p=0.011), and BIS-11 (p=0.012) in the CBT-MT group were significantly greater than those in the CBT group. Conclusion Combined MT and CBT improved the symptoms of smartphone/internet addiction, anxiety, and impulsivity in adolescents. This combination could therefore be an effective treatment of smartphone or internet addiction along with behavioral disorders such as anxiety and impulsivity.     

Intolerance of Uncertainty Mediates the Influence of Viral Anxiety on Social Distancing Phobia Among the General Korean Population During the Coronavirus Disease 2019 Pandemic

Objective We aimed to examined the reliability and validity of Korean version of Social Distancing Phobia scale, and whether intolerance of uncertainty mediates the association of the general population’s social distancing phobia with viral anxiety and depression. Methods Through this anonymous online survey, we collected responses from 400 individuals in the general Korean population. Participants’ demographic information and rating scales scores, including the Social Distancing Phobia scale, Stress and Anxiety to Viral Epidemics-6 items, Patient Health Questionnaire-9, and Intolerance of Uncertainty-12 items. Results Confirmatory factor analysis showed a good model fit, and the Korean version of Social Distancing Phobia scale showed good internal consistency. Social distancing phobia was significantly correlated with age (r=0.213, p<0.001), viral anxiety (r=0.390, p<0.001), depression (r=0.244, p<0.001), and intolerance of uncertainty (r=0.323, p<0.001). A linear regression analysis showed that age (β=0.235, p<0.001), viral anxiety (β=0.281, p<0.001), depression (β=0.121, p=0.009), and intolerance of uncertainty (β=0.200, p<0.001; adjusted R²=0.246, F=33.6, p<0.001) predicted social distancing phobia. Mediation analysis revealed that viral anxiety directly influenced social distancing phobia (z=6.48, p<0.001), and intolerance of uncertainty partially mediated this association (z=2.92, p=0.003). Conclusion Social distancing phobia may cause psychological stress but may also increase adherence to physical distancing measures and prevent the spread of viruses.     

Mediating Effect of Public Service Motivation and Resilience on the Association Between Work-Related Stress and Work Engagement of Public Workers in the COVID-19 Pandemic

Objective We aimed to explore the influence of public workers’ distress or viral anxiety on their level of depression and work engagement during the coronavirus disease (COVID-19) pandemic. Additionally, we ascertain the mediation effect of resilience and public service motivation on this association. Methods A total of 300 public workers participated in this online survey. Their demographic characteristics and responses to survey items were collected using the Stress and Anxiety to Viral Epidemics–6 items Scale, the Patient Health Questionnaire–9 items Scale, the Public Service Motivation (PSM) Scale, the Nine-item Utrecht Work Engagement Scale, the Korean Occupational Stress Scale–Short Form, and the Brief Resilience Scale. Results Work engagement of public workers was expected by PSM (β=0.28, p<0.001), resilience (β=0.30, p<0.001), and work-related stress (β=-0.40, p<0.001) (F=57.4, p<0.001). Depression was expected by fewer years of employment (β=-0.12, p=0.02), viral anxiety (β= 0.21, p<0.001), and low resilience (β=-0.42, p<0.001) (F=22.1, p<0.001). Resilience and PSM partially mediated the effects of work-related stress on work engagement. Depression was influenced by COVID-19–induced viral anxiety, and their resilience—but not PSM—mediated the association. Conclusion Public workers’ resilience and PSM partially mediated the effects of work-related stress on work engagement. The influence of viral anxiety on public workers’ depression was mediated by their resilience but not PSM.     

The Relationship of Smartphone Addiction and Alexithymia

ObjectiveThis study aims to evaluate whether smartphone addiction (SA) is associated with social media use and alexithymia levels in university students. MethodsA group of 935 students aged between 18 and 45 years (509 females and 426 males) was recruited from different universities in Istanbul. SAs, alexithymia and social media use were assessed using the Smartphone Addiction Scale Short Version (SAS-SV), Toronto Alexithymia Scale-20 (TAS-20), and ad-hoc questions regarding social media use. ResultsThe mean age of participants was 21.89±3.27 years and 509 of participants were female (54.4%). 455 (48.6%) participants were placed in the “SA” and 198 (21.2%) in the “alexithymia” categories. The study found a high level of positive correlation (p<0.001) between both subscale and total TAS-20 scores and SAS-SV scores. Gender (OR=1.496, 95% CI 1.117–2.002, p=0.007) and number of social media by participants (OR=1.221, 95% CI 1.134–1.315, p<0.001) and TAS (OR=1.074, 95% CI 1.059–1.090, p<0.001) were found to be an independent predictors for SA. ConclusionThe study revealed a positive correlation between alexithymia and smartphone use severity, and alexithymia was a significant predictor of SA. Future studies focusing on the causal aspect of this relationship will be useful in planning strategies for treatment.     

Validation of the Individualized Neuromuscular Quality of Life Questionnaire in Korean Patients With Genetic Neuromuscular Diseases

Background and PurposeThe Individualized Neuromuscular Quality of Life questionnaire (INQoL) is a widely used measure of the quality of life in patients with neuromuscular diseases. The purpose of this study was to translate and validate the Korean version of INQoL in Korean patients with neuromuscular diseases.MethodsWe translated the original INQoL version into Korean while applying appropriate language adaptations. The internal consistency, known-group validity, and test-retest reliability were also assessed. Construct validity was measured using the modified Rankin Scale (mRS) score and the manual muscle testing (MMT)-sum score based on the Medical Research Council scale, and concurrent validity was measured using the 36-item Short Form Survey (SF-36) questionnaire.ResultsThis study enrolled 193 patients. The coefficients for internal consistency (Cronbach’s α=0.805 to 0.987) and test-retest reliability (Spearman’s ρ=0.453 to 0.886) were adequately high for all subscales except in the ‘treatment effects’ dimension. INQoL subscales other than those for locking, droopy eyelids, double vision, and swallowing difficulties were significantly associated with their relevant SF-36 domains (Spearman’s ρ=-0.274 to -0.833). Functional status and muscle strength were most strongly associated with independence (Spearman’s ρ=0.753 and p<0.001 for mRS score, Spearman’s ρ=-0.741 and p<0.001 for MMT-sum score).ConclusionsThe Korean INQoL is a reliable and validated measurement tool for Korean patients with neuromuscular diseases.     

Quantitative Susceptibility Mapping of Brain Iron Deposition in Patients With Recurrent Depression

Objective Recurrence is the most significant feature of depression and the relationship between iron and recurrent depression is still lack of direct evidence in vivo. Methods Twenty-one patients with depression and twenty control subjects were included. Gradient-recalled echo, T1 and T2 images were acquired using a 3.0T MRI system. After quantitative susceptibility mapping were reconstructed and standardized, a whole-brain and the regions of interest were respectively analyzed. Results Significant increases in susceptibility were found in multiple recurrent depression patients, which involved several brain regions (frontal lobes, temporal lobe structures, occipital lobes hippocampal regions, putamen, thalamus, cingulum, and cerebellum). Interestingly, no susceptibility changes after treatment compared to pre-treatment (all p>0.05) and no significant correlation between susceptibility and Hamilton Depression Rating Scale were found. Besides, it was close to significance that those with a higher relapse frequency or a longer mean duration of single episode had a higher susceptibility in the putamen, thalamus, and hippocampus. Further studies showed susceptibility across the putamen (ρ²=0.27, p<0.001), thalamus (ρ²=0.21, p<0.001), and hippocampus (ρ²=0.19, p<0.001) were strongly correlated with total course of disease onset. Conclusion Brain iron deposition is related to the total course of disease onset, but not the severity of depression, which suggest that brain iron deposition may be a sign of brain damage in multiple recurrent depression.     

Effects of the combination of second-generation antipsychotics on serum concentrations of aripiprazole and dehydroaripiprazole in Chinese patients with schizophrenia

BackgroundAripiprazole (ARI) is often prescribed alone or in combination with other second-generation antipsychotics (SGAs) to treat patients with schizophrenia. However, this may increase the potential clinical significance of drug–drug interactions. Therapeutic drug monitoring (TDM) is an important and fundamental tool both when administering ARI alone and in combination with other SGAs to monitor ARI pharmacokinetics, adjust the dosage and thereby achieve more effective and safer treatment.AimsThis study retrospectively investigated the effects of four SGA comedications (clozapine, risperidone, quetiapine (QTP) and olanzapine) and other potential factors (sex, age and ARI dose) on the serum concentrations of ARI and dehydroaripiprazole (DARI) in Chinese patients with schizophrenia using TDM data.MethodsHigh-performance liquid chromatography was used to test the serum concentrations of ARI, DARI and ARI+DARI. In addition, steady-state dose-adjusted serum concentrations (ie, concentration-to-dose ratios, C:D ratios) of ARI, DARI and ARI+DARI; sex; age; ARI dose and SGA comedication dose between 299 inpatients with schizophrenia who received ARI or SGA comedication were all collected and analysed. Spearman’s correlation and multiple linear regression analysis were used to evaluate bivariate associations between ARI dose and serum ARI and DARI concentrations and describe the effect of independent variables on serum ARI and DARI concentrations, respectively.ResultsThere were significant differences in the C:D ratios of ARI (χ²=−3.21, p=0.001) and ARI+DARI (χ²=−2.50, p=0.01) between the ARI and SGA groups, as well as in the C:D ratios of ARI (χ²=−3.59, p<0.001) and ARI+DARI (χ²=−3.10, p=0.002) between the female patients in the two groups. Of the four SGAs, only QTP had significant effects on the C:D ratios of ARI (Z=−4.12, p<0.001) and ARI+DARI (Z=−3.62, p<0.001) when compared with the ARI group in the whole sample and on the C:D ratios of ARI, DARI and ARI+DARI (Z=−3.96, p<0.001; Z=−2.22, p=0.03; Z=−3.75, p<0.001, respectively) in women when compared with their counterparts in the ARI group.ConclusionComedication with SGAs resulted in lower C:D ratios of ARI and ARI+DARI compared with ARI monotherapy, and comedication with QTP resulted in lower C:D ratios of ARI and ARI+DARI than ARI monotherapy. Despite this statistical significance of our findings, whether the presently observed effect has clinical significance requires exploration by further research. TDM and dosage regulation of ARI should be performed in Chinese inpatients with schizophrenia who are receiving SGA comedication (especially QTP) to maintain a safe and effective dose-adjusted serum concentration of ARI and DARI.     

Discrepancy Between Desired Time in Bed and Desired Total Sleep Time,Insomnia, Depression,and Dysfunctional Beliefs About Sleep Among the General Population

Objective The aim of this study was to explore the factors that can influence the severity of insomnia in the general population. We also aimed to examine whether sleep effort mediates the association between dysfunctional beliefs about sleep or the discrepancy between desired time in bed and desired total sleep time (DBST) and insomnia severity in individuals. Methods A total of 387 participants enrolled in this e-survey study. The symptoms were rated using the insomnia severity index (ISI), Patients Health Questionnaire-9 items, Dysfunctional Beliefs about Sleep-2 items, Glasgow Sleep Effort Scale, and Stress and Anxiety to Viral Epidemics-6 items. In addition, we defined a new sleep index named the DBST index. A linear regression analysis was performed to explore the factors predicting ISI scores, and mediation analysis was implemented to explore whether persistent preoccupation with sleep mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity. Results A linear regression analysis investigated depression (β=0.17, p<0.001), sleep effort (β=0.50, p<0.001), dysfunctional beliefs about sleep (β=0.13, p=0.001), and DBST (β=0.09, p=0.014) (adjusted R²=0.50, F=65.7, p<0.001). Additionally, we observed that persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity. Conclusion Depression, preoccupation with sleep, dysfunctional beliefs about sleep, and DBST influenced the insomnia severity of the general population. We also observed that a persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and the DBST index on insomnia severity.     

Association between Working Hours and Anxiety/Depression of Medical Staff during Large-Scale Epidemic Outbreak of COVID-19: A Cross-Sectional Study

Objective This present study aimed to investigate the relationship between working hours and anxiety/depression mood of medical staff in China during COVID-19 epidemic. Methods The cross-sectional interview study was conducted during the period between February 14th and February 29th, 2020. A total of 291 Chinese medical professionals were recruited from 4 cities and participated in the study. Results In 291 participants, 116 (40.0%) medical staff experienced anxiety and 151 (51.8%) underwent depressed mood. In male, the level of GAD-7 and PHQ-9 scores increased with the elevation of working hours per day (WHPD) (β=0.579, p=0.003 and β=0.943; p=0.001) respectively. In female, nonlinear relationship mode was demonstrated. The levels of GAD-7 and PHQ-9 scores increased with the elevation of working hours when it was above 5 hours (β=1.432; p<0.001 and β=1.177; p<0.001), but it did not have a significant association with WHPD when it was less than 5 (p>0.05). Conclusion During the COVID-19 epidemic, we found a strong correlation between the psychological mood and WHPD. The correlation followed different modes in male and female medical workers. Enforcing an upper time limit of WHPD may help decrease the risk of pandemic-related psychological problems in medical workers.     

A Call for a Rational Polypharmacy Policy: International Insights From Psychiatrists

ObjectiveRecently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy. Based on this, the association between the policy and psychiatrists’ attitude toward polypharmacy has been under debate. MethodsWe developed an original questionnaire about Psychiatrists’ attitudes toward polypharmacy (PAP). We compared the PAP scores with the treatment decision-making in clinical case vignettes. Multiple regression analyses were performed to quantify associations of explanatory variables including policy factors and PAP scores. The anonymous questionnaires were administered to psychiatrists worldwide. ResultsThe study included 347 psychiatrists from 34 countries. Decision-making toward polypharmacy was associated with high PAP scores. Multiple regression analysis revealed that low PAP scores were associated with the policy factor (β=-0.20, p=0.004). The culture in Korea was associated with high PAP scores (β=0.34, p<0.001), whereas the culture in India and Nepal were associated with low scores (β=-0.15, p=0.01, and β=-0.17, p=0.006, respectively). ConclusionPolicy on polypharmacy may influence psychiatrists’ decision-making. Thus, policies considering rational polypharmacy should be established.     

Predictors of Developmental Outcome in 4- to 6-Year-Olds With Developmental Disability

Objective Studies on the early trajectories of developmental disability (DD) are limited. This study aimed to evaluate the diagnostic stability and developmental trajectories of autism spectrum disorder (ASD) and intellectual disability (ID), and to determine baseline clinical characteristics that affect future diagnosis. Methods We analyzed 192 children who were referred for possible DD through retrospective chart review. Clinical diagnosis was assessed once at baseline, aged 2–4, and at follow-up, aged 4–6. The participants’ developmental profiles were measured by Psychoeducational Profile-Revised (PEP-R), Vineland Social Maturity Scale (VSMS), Beery-Buktenica Developmental Test of Visual Motor Integration (VMI), and Childhood Autism Rating Scale (CARS). Results On comparing the diagnostic change, 5% of children were no longer diagnosed as ASD, and 13% of children were no longer diagnosed as ID at follow-up. Trajectories of developmental profiles were compared between children with and without ID at follow-up, and significant time-by-group interaction were observed in PEP-R (p<0.001), VSMS (p<0.001), and VMI (p=0.003) scores, indicating that children without ID at follow-up showed significant improvement over time compared to children with ID. ASD diagnosis (p<0.001) and CARS score (p=0.007) at baseline were significantly associated with ASD at follow-up, while VSMS score (p=0.004) and VMI score (p=0.019) at baseline were significantly associated with ID at follow-up. Conclusion A subset of children lost their diagnosis at follow-up, and such diagnostic change was significantly more common in ID compared to ASD. Baseline autism symptomatology was related to ASD at follow-up, and baseline adaptive and visuo-motor function was related to ID at follow-up.     

Smartphone Usage and Sleep Quality in Korean Middle School Students During the COVID-19 Pandemic

Objective This study evaluated the quality of sleep and smartphone addiction in Korean adolescents during the coronavirus disease 19 pandemic and analyzed their effects on perceived quality of life. Methods An online survey system provided by the Gwangmyeong City Health Center located in Gyeonggi-do, Korea, was completed by 1,678 local middle school students from April 1 to June 30, 2021. We measured quality of life using the KIDSCREEN-27 health-related quality of life questionnaire, quality of sleep using the Korean version of the Pittsburgh Sleep Quality Index, and smartphone addiction using the Smartphone Addiction Self-Diagnosis Scale. Bed times, wake times, and total sleep hours were also recorded. Results Sleep quality and quantity were directly associated with smartphone addiction. The results indicated that lower quality of life was associated with lower sleep quality, delayed onset of sleep, shorter total sleep time, and higher smartphone addiction. Female students reported lower quality of life, lower sleep quality, delayed sleep phases, shorter total sleep hours, and higher smartphone addiction scores than did male students. Conclusion Our results suggest that adolescents’ quality of life is threatened by poor sleep, which in turn could be due to unhealthy smartphone usage. Girls were more heavily affected by this trend than were boys. Preparations to intervene for further mental health issues that might follow are necessary.     

Sex Differences in Obstructive Sleep Apnea by Bioelectrical Impedance Analysis

Background and PurposeObesity is known of one of the risk factors for obstructive sleep apnea (OSA). Although body mass index (BMI) can be an indicator for obesity, it does not represent the actual body composition of fat or muscle. We hypothesized that bioelectrical impedance analysis (BIA) can help analyze the fat and muscle distributions in males and females with OSA.MethodsThis study screened subjects who visited the Department of Neurology, Samsung Medical Center, Seoul, Korea due to sleep disturbances with symptoms suggestive of OSA from December 2017 to December 2019. All subjects underwent overnight type I polysomnography (PSG) and BIA.ResultsPSG and BIA were completed in 2,064 OSA patients who had an apnea-hypopnea index (AHI) of ≥5/hour (77.1% males and 22.9% females). The females had remarkably higher fat indicators and lower muscle indicators. The AHI was significant correlated with all BIA parameters in all OSA patients: body fat mass (ρ=0.286, p<0.001), percentage body fat (ρ=0.130, p<0.001), visceral fat area (VFA) (ρ=0.257, p<0.001), muscle mass (ρ=0.275, p<0.001), and skeletal muscle mass (SMM) (ρ=0.270, p<0.001). The correlations in males were similar to those in all patients, where those in females were not. In females with OSA, all of the BIA fat indicators were correlated with AHI, whereas the muscle indicators were not. Adjusting age and BMI when analyzing the SMM/VFA ratio showed a strong correlation in males with OSA (p=0.015) but not in females with OSA (p=0.354).ConclusionsThis study has revealed that the body composition of fat and muscle has different patterns in OSA patients. The SMM/VFA as measured using BIA is the factor most significantly associated with AHI in males but not in females after adjusting for age and BMI.     

Corpus callosum in schizophrenia with deficit and non-deficit syndrome: a statistical shape analysis

BackgroundThe corpus callosum (CC) is the most targeted region in the cerebrum that integrates cognitive data between homologous areas in the right and left hemispheres.AimsOur study used statistical analysis to determine whether there was a correlation between shape changes in the CC in patients with schizophrenia (SZ) (deficit syndrome (DS) and non-deficit syndrome (NDS)) and healthy control (HC) subjects.MethodsThis study consisted of 27 HC subjects and 50 schizophrenic patients (20 with DS and 30 with NDS). 3 patients with DS and 4 patients with NDS were excluded. Three-dimensional, sagittal, T1-spoiled, gradient-echo imaging was used. Standard anatomical landmarks were selected and marked on each image using specific software.ResultsAs to comparing the Procrustes mean shapes of the CC, statistically significant differences were observed between HC and SZ (DS+NDS) (p=0.017, James’s F_j=73.732), HC and DS (p<0.001, James’s F_j=140.843), HC and NDS (p=0.006, James’s F_j=89.178) and also DS and NDS (p<0.001, James’s F_j=152.967). Shape variability in the form of CC was 0.131, 0.085, 0.082 and 0.086 in the HC, SZ (DS+NDS), DS and NDS groups, respectively.ConclusionsThis study reveals callosal shape variations in patients with SZ and their DS and NDS subgroups that take into account the CC’s topographic distribution.     

Relationship between screen time and sleep among Finnish preschool children: results from the DAGIS study

Study objectivesTo examine the associations between screen time, the time spent on different screen devices, and sleep in a sample of Finnish preschool children.MethodsThe current study analyzed cross-sectional data from the DAGIS study carried out in Finland in 2015–2016 on 736 children aged 3–6 years. Parents reported in a 7-day diary the durations the child used screen devices daily, with separate details about watching TV or DVDs, using tablets or smartphones, and using computers. In addition, parents reported children's bedtimes and wake-up times, which were further used in calculating sleep duration. Parents answered questions regarding their child's sleep consistency. Statistical analyses included adjusted general linear modeling.ResultsAn hourly increase in total screen time was associated with 11 min later bedtime (p < 0.001) and 10 min shorter sleep duration (p < 0.001). More TV/DVD watching was associated with later bedtimes (p = 0.016) and a shorter sleep duration (p = 0.001). More smartphone/tablet use was associated with later bedtimes (p = 0.005), later wake-up times (p = 0.038), and weaker sleep consistency (p = 0.024). More computer use was associated with later bedtimes (p = 0.046). Results did not differ between genders.ConclusionsIncreased screen time was associated with later bedtimes and shorter sleep duration among preschool children. Adverse associations with sleep outcomes were found for each screen device. Attention should be paid to promoting balanced use of screens and regular sleep habits in young children.     

Application of Stress and Anxiety to Viral Epidemics-6 to Measure the Anxiety Response of Cold Chain Practitioners During the COVID-19 Post-Pandemic Era in China

ObjectiveThis study explored the psychometric properties of the Chinese version of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) scale for cold chain practitioners exposed to moderate-to-high risk of infection. MethodsA total of 233 cold chain practitioners participated in an anonymous online survey, conducted from October to November 2021. The questionnaire comprised participant demographic characteristics, the Chinese version of SAVE-6, the Generalized Anxiety Disorders-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) scales. ResultsBased on the results of the parallel analysis, the single-structure model of the Chinese version of SAVE-6 was adopted. The scale showed satisfactory internal consistency (Cronbach’s alpha=0.930) and good convergent validity based on Spearman’s correlation coefficient with the GAD-7 (rho=0.616, p<0.001) and PHQ-9 (rho=0.540, p<0.001) scale scores. The optimal cutoff score for Chinese Stress and Anxiety to Viral Epidemics-9 Items was identified as ≥12 (area under the curve=0.797, Sensitivity=0.76, Specificity=0.66) for cold chain practitioners. ConclusionThe Chinese version of the SAVE-6 scale has good psychometric properties and can be applied as a reliable and valid rating scale to assess the anxiety response of cold chain practitioners in the post-pandemic era.     

Childhood Emotional Abuse Is Associated With the Desire to Get Married and Have Children in Korean Young Adults

ObjectiveYoung adults putting off marriage and having less children have become recent trends in many modern societies. Yet less is known about the psychological factors underlying the drastically low marriage and fertility rates. We hypothesized that childhood maltreatment experience may have a negative association with one’s marriage and childbearing intention. MethodsA total of 1,004 college students (mean age of 20.8±2.3 years, 56.1% female) completed self-questionnaires including sociodemographic information, marriage and childbearing intention, Patient Health Questionnaire 9 (PHQ-9), and Childhood Trauma Questionnaire (CTQ). Multivariable logistic regression analyses were conducted to evaluate the effect of childhood trauma on marriage and childbearing intentions after controlling for sociodemographic variables and depression. Results29.7% had no intention to get married and 40.4% had no intention to have children in the future. The prevalence of physical, sexual, and emotional abuse was 33.1%, 18.5%, and 22.3%, respectively. Multivariable logistic regression analyses revealed that female (p<0.001), poor health status (p=0.001), and childhood emotional abuse (p=0.01) were independent predictors of no desire to get married. Female (p<0.001), poor health status (p<0.001), and childhood emotional abuse (p=0.038) were also predictors of no desire to have children. ConclusionChildhood emotional abuse may be the most damaging form among other types of childhood maltreatment because it can occur more pervasively and persist for a longer period, causing extensive damage to a child’s emotional, social and cognitive development. Raising awareness regarding the life-long consequences of childhood emotional abuse and the need to prevent and detect childhood emotional abuse should be emphasized.     

Neuroanatomical correlates of reality monitoring in patients with schizophrenia and auditory hallucinations

BackgroundReality-monitoring process enables to discriminate memories of internally generated information from memories of externally derived information. Studies have reported impaired reality-monitoring abilities in schizophrenia patients with auditory hallucinations (AHs), specifically with an exacerbated externalization bias, as well as alterations in neural activity within frontotemporoparietal areas. In healthy subjects, impaired reality-monitoring abilities have been associated with reduction of the paracingulate sulcus (PCS). The current study aimed to identify neuroanatomical correlates of reality monitoring in patients with schizophrenia.MethodsThirty-five patients with schizophrenia and AHs underwent a reality-monitoring task and a 3D anatomical MRI scan at 1.5 T. PCS lengths were measured separately for each hemisphere, and whole-brain voxel-based morphometry analyses were performed using the Computational Anatomy Toolbox (version 12.6) to evaluate the gray-matter volume (GMV). Partial correlation analyses were used to investigate the relationship between reality-monitoring and neuroanatomical outcomes (PCS length and GMV), with age and intracranial volume as covariates.ResultsThe right PCS length was positively correlated with reality-monitoring accuracy (Spearman’s ρ = 0.431, p = 0.012) and negatively with the externalization bias (Spearman’s ρ = −0.379, p = 0.029). Reality-monitoring accuracy was positively correlated with GMV in the right angular gyrus, whereas externalization bias was negatively correlated with GMV in the left supramarginal gyrus/superior temporal gyrus, in the right lingual gyrus and in the bilateral inferior temporal/fusiform gyri (voxel-level p < 0.001 and cluster-level p < 0.05, FDR-corrected).ConclusionsReduced reality-monitoring abilities were significantly associated with shorter right PCS and reduced GMV in temporal and parietal regions of the reality-monitoring network in schizophrenia patients with AHs.